Cauda Equina Syndrome and Denervated Muscle: Your Options for Long-Term Health

Cauda equina syndrome (CES) is one of the most challenging situations in spinal cord injury rehabilitation. Unlike injuries higher in the spine, CES directly damages the lower motor neurons—the nerve cells that connect to and control the leg muscles. This results in the muscles becoming denervated, losing their nerve supply completely.

For many years, people with CES were told little could be done about the muscle wasting that occurs. The common belief was that denervated muscles would inevitably weaken, and electrical stimulation—which is effective for higher spinal injuries—simply wouldn't help. That perspective has shifted.

Research over the past twenty years shows that denervated muscles can be preserved and even improved with appropriate electrical stimulation—however, it requires a different approach from standard rehabilitation methods. In this article, I will explain what happens to muscles after cauda equina syndrome, why conventional methods often fail, and what options are available for maintaining long-term muscle and tissue health.

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